Title page for ETD etd-04072004-180148

Type of Document Master's Thesis
Author Minshawi, Noha Farrah
URN etd-04072004-180148
Title Reliability and Concordance of the Childhood Autism Rating Scale and DSM-IV in Adults with Severe and Profound Mental Retardation
Degree Master of Arts (M.A.)
Department Psychology
Advisory Committee
Advisor Name Title
Johnny Matson Committee Chair
George Noell Committee Member
W. Drew Gouvier Committee Member
  • childhood autism rating scale
  • DSM-IV
  • autism
  • mental retardation
Date of Defense 2004-03-25
Availability unrestricted
Researchers and clinicians have long treated autism as though it were a disorder that only affected children. As a result, little literature is available on the diagnosis, assessment, and treatment of adults with autism. One of the first issues to address in this population is diagnosis. While several rating scales and diagnostic systems exist for surveying autistic behavior in children, researchers have not demonstrated the reliability of these scales for adults. The present study focused on two commonly used instruments, the Childhood Autism Rating Scale (CARS) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). In the first objective, reliability of the two instruments was established using two types of informants: direct-care staff and trained mental health professionals. Test-retest reliability of the CARS using direct-care staff informants was good and better than the test-retest reliability of the DSM-IV criteria, which was acceptable. Interrater reliability between two direct-staff, as well as between direct-care staff and trained mental health professionals was unacceptable for clinical use. The second objective of the study was to assess concordance between CARS and DSM-IV diagnoses. For both direct-care staff and trained mental health professionals, CARS and DSM-IV diagnoses concurred at a rate greater than that expected by chance. In the final portion of the study, CARS scores and DSM-IV diagnoses for individuals with profound mental retardation (PMR; n = 46) and severe mental retardation (SMR; n = 46) were compared as a preliminary step towards determining the appropriateness of these two instruments in individuals with mental retardation. The PMR group had significantly higher CARS scores and significantly more DSM-IV diagnoses than the SMR group. Results and implications of the study are discussed.
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